By Dr. Kate O’Brien
Today is a landmark day, one that many global health experts thought might not happen. Today marks three years since the last case of wild polio in India, the requirement to officially certify the country, and with it the WHO South-East Asia Region, polio-free. While the official declaration is not due until March when a WHO Regional Certification Committee reviews all the data, today is a day to celebrate and to be remembered in India and around the world for years to come.
Photo Credit: Rotary International
It is a day to congratulate India, but also the global community. It is a day that gives us all strengthened hope and confidence in achieving the goal of global polio eradication. In 1998, India had a high of nearly 2,000 cases of paralytic polio from the wild poliovirus, and as recently as 2009, it still was home to most of the world’s polio cases. By 2011, it had wiped out wild polio cases, and now it has maintained that status for three years. India’s large, dense, and often migratory population combined with poor sanitation conditions in parts of the country created some of the most difficult conditions throughout the world to control disease. However, with a depth of commitment from all levels of government and civil society and dedication of significant resources, India achieved this mammoth goal. It could not have been done without the work of millions of individuals, including the 2.3 million vaccinators, the thousands of clinicians and epidemiologists in more than 33,000 surveillance sites, the religious leaders and advocates committed to on-the-ground outreach, and the leaders across government and industry who together contributed nearly US$2 billion in funding.
Thanks to all of these individuals, India is now polio-free, and its triumph over polio is a massive public health achievement---one that will leave a lasting impact on children's health in India and around the world. It is also a testament to the power of immunizations, which have been saving lives in India and around the world for centuries.
India has achieved a laudable reduction in global child deaths in recent years, and vaccines have been one of the most effective interventions in this effort. Not only have vaccines prevented deaths, but they’ve also helped children stay healthy and averted crippling social and economic costs to families and society. Beyond polio, India’s other great achievements related to vaccines are highlighted in this infographic.
Vaccines clearly work and they clearly work in India. As coverage levels increase and new vaccines are introduced into its Universal Immunization Programme, disease reduction will amplify, and children will lead healthier, longer lives. These inspiring efforts should be applauded along with India’s polio achievement.
India’s achievements should also inspire the global community to rededicate our efforts to ensure every child around the world is protected from preventable diseases. We have a unique window of opportunity to change history by eliminating polio from the three remaining countries where transmission has not yet been stopped – Pakistan, Afghanistan, and Nigeria – and maintaining disease control in other countries where elimination is fragile and polio threatens to return. With much learned from India’s success, communities, countries and the global community have a strong, actionable plan to achieve a polio-free world by 2018.
Ending polio everywhere, forever, is a critical step toward improving the lives of the world’s most vulnerable children. As India has clearly shown, polio eradication can lead the way for other child health initiatives, by strengthening surveillance systems, building networks of trained community health workers, and engaging leaders from across diverse disciplines. The job is not yet done; India and other countries around the world will need to sustain and continue to build on the progress to date while planning for the next step of introducing at least one dose of inactivated polio vaccine.
The remaining polio-endemic countries should have a deep sense of hope, bolstered by the accomplishments and lessons learned in India, that this goal is at their fingertips. The scientific, public health, communication, and organizational tools are in place. With the right political will, polio will be wiped out; there will remain substantial and at times unanticipated challenges to match the accomplishment of India in the remaining countries, but these are surmountable. There is a lot to be optimistic about. India has demonstrated to the world what is possible when the community in all its dimensions – local and global, political and religious, scientific and lay – has a common commitment. We call on all partners to continue without wavering the march toward worldwide polio eradication and in so doing achieve the purest measure of health equity.
Kate O’Brien, MD, MPH, is Executive Director of IVAC. A pediatric infectious disease physician, epidemiologist, and vaccinologist, she previously served as Deputy Director of IVAC. She also serves as Associate Director of the Center for American Indian Health.